Abstract The purpose of this study was to investigate the blood levels of methadone in participants receiving methadone for the treatment of opioid dependence. After stabilization on methadone for four weeks, blood sa...Abstract The purpose of this study was to investigate the blood levels of methadone in participants receiving methadone for the treatment of opioid dependence. After stabilization on methadone for four weeks, blood samples from 95 participants were collected between treatment weeks 4 and 12, before and after receiving doses of methadone, and its blood levels were measured. A multiple linear regression model was used to examine the associa- tion between methadone blood levels and the outcomes of methadone maintenance treatment （MMT）. Outcome dif- ferences between participants who had high （≥2） or low （〈2） peak-to-trough ratios were also compared using an independent sample t-test. The blood level of methadone was not correlated with the clinical outcome of MMT with the moderate range of doses given. However, the retention of patients who had a free peak-to-trough ratio 〉2 was significantly poorer than those whose ratio was 〈2. Thus, monitoring plasma methadone levels is unlikely to be effective for guiding dosing decisions in situations where compliance with MMT is already very high or when themethadone dose is no longer the dominant factor in determining the clinical outcome. However, monitoring plasma methadone levels is still helpful for guiding the dosage for patients with a rapid metabolism.展开更多
Objective This study examined the gender differences in drug‐related problems and predictors of recidivism among a sample of 1444 offenders with co‐morbid drug abuse and mental disorders participating in California...Objective This study examined the gender differences in drug‐related problems and predictors of recidivism among a sample of 1444 offenders with co‐morbid drug abuse and mental disorders participating in California＇s Proposition 36 Program.Methods Background characteristics and problem severity in multiple key life areas were assessed at intake by using Addiction Severity Index,and drug treatment participation,mental health diagnoses and arrests were based on official records.Results Women demonstrated greater problem severity than men in family relationships,health,psychological health,and sexual and physical abuse history.Men on the other hand had greater criminal history,high rates of attention disorder,and psychotic disorder.More men than women were rearrested during the year after treatment admission.Logistic regression analyses showed that for the combined sample,male,young age,cocaine use（relative to methamphetamine）,drug abuse severity,methadone treatment,arrest history and fewer prior treatment history were associated with higher recidivism at 12‐month follow‐up;lower education,cocaine use,and arrest history were related to women＇s recidivism,while young age,outpatient treatment,and arrest history were predictors of men＇s recidivism.Conclusion Although the specific type of mental disorder did not seem to be predictive of recidivism,the high rates of mental health disorder and arrest of this population is problematic.Intervention strategies taking into consideration gender‐specific problems and needs can improve outcomes for both.展开更多
Abundant literature suggests the hypothesis that cannabis use leads to the onset of psychotic symptoms. However, the nature of the association and the causal link remain controversial. This review aims to identify the...Abundant literature suggests the hypothesis that cannabis use leads to the onset of psychotic symptoms. However, the nature of the association and the causal link remain controversial. This review aims to identify the risk factors involved in the etiopathogenesis of psychosis or psychotic features. Our electronic search found 1653 studies published until March 1<sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> 2020. Longitudinal studies and literature reviews were selected if they addressed specifically the issues of the cannabis/psychosis relationship and the eventual risk factors involved. Our systematic review identified six potential risk factors involved in the association. They are, in decreasing importance, the dose-response relationship (quantity, frequency and duration of cannabis use), the early age of cannabis consumption, genetic susceptibility, childhood trauma, cigarette smoking and urban environment. In contrast, a significant inverse relationship exists between cannabidiol (CBD) and psychosis: cannabidiol is associated with less psychotic symptoms and manifests antipsychotic properties. Further studies are needed to establish a clear causal relationship between cannabis and psychosis and to identify the qualitative and quantitative contribution of specific risk factors on its onset and sustainability.</span>展开更多
基金supported by the Research Project of Shanghai Municipal Health and Family Planning Commission, China(2013SY011 and 2014ZYJB0002)the National Natural Science Foundation of China(81271468)+1 种基金Doctoral Supervisor Funding from the Ministry of Education of China(20120073110089)Research Funding from Shanghai Key Laboratory of Severe Mental illness,China(13dz2260500)
文摘Abstract The purpose of this study was to investigate the blood levels of methadone in participants receiving methadone for the treatment of opioid dependence. After stabilization on methadone for four weeks, blood samples from 95 participants were collected between treatment weeks 4 and 12, before and after receiving doses of methadone, and its blood levels were measured. A multiple linear regression model was used to examine the associa- tion between methadone blood levels and the outcomes of methadone maintenance treatment （MMT）. Outcome dif- ferences between participants who had high （≥2） or low （〈2） peak-to-trough ratios were also compared using an independent sample t-test. The blood level of methadone was not correlated with the clinical outcome of MMT with the moderate range of doses given. However, the retention of patients who had a free peak-to-trough ratio 〉2 was significantly poorer than those whose ratio was 〈2. Thus, monitoring plasma methadone levels is unlikely to be effective for guiding dosing decisions in situations where compliance with MMT is already very high or when themethadone dose is no longer the dominant factor in determining the clinical outcome. However, monitoring plasma methadone levels is still helpful for guiding the dosage for patients with a rapid metabolism.
基金supported by the NIDA(Grants R01DA15431and P30DA016383)National Key Clinical Disciplines at Shanghai Mental Health Center(Office of Medical Affairs,Ministry of Health,2011-873)
文摘Objective This study examined the gender differences in drug‐related problems and predictors of recidivism among a sample of 1444 offenders with co‐morbid drug abuse and mental disorders participating in California＇s Proposition 36 Program.Methods Background characteristics and problem severity in multiple key life areas were assessed at intake by using Addiction Severity Index,and drug treatment participation,mental health diagnoses and arrests were based on official records.Results Women demonstrated greater problem severity than men in family relationships,health,psychological health,and sexual and physical abuse history.Men on the other hand had greater criminal history,high rates of attention disorder,and psychotic disorder.More men than women were rearrested during the year after treatment admission.Logistic regression analyses showed that for the combined sample,male,young age,cocaine use（relative to methamphetamine）,drug abuse severity,methadone treatment,arrest history and fewer prior treatment history were associated with higher recidivism at 12‐month follow‐up;lower education,cocaine use,and arrest history were related to women＇s recidivism,while young age,outpatient treatment,and arrest history were predictors of men＇s recidivism.Conclusion Although the specific type of mental disorder did not seem to be predictive of recidivism,the high rates of mental health disorder and arrest of this population is problematic.Intervention strategies taking into consideration gender‐specific problems and needs can improve outcomes for both.
文摘Abundant literature suggests the hypothesis that cannabis use leads to the onset of psychotic symptoms. However, the nature of the association and the causal link remain controversial. This review aims to identify the risk factors involved in the etiopathogenesis of psychosis or psychotic features. Our electronic search found 1653 studies published until March 1<sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> 2020. Longitudinal studies and literature reviews were selected if they addressed specifically the issues of the cannabis/psychosis relationship and the eventual risk factors involved. Our systematic review identified six potential risk factors involved in the association. They are, in decreasing importance, the dose-response relationship (quantity, frequency and duration of cannabis use), the early age of cannabis consumption, genetic susceptibility, childhood trauma, cigarette smoking and urban environment. In contrast, a significant inverse relationship exists between cannabidiol (CBD) and psychosis: cannabidiol is associated with less psychotic symptoms and manifests antipsychotic properties. Further studies are needed to establish a clear causal relationship between cannabis and psychosis and to identify the qualitative and quantitative contribution of specific risk factors on its onset and sustainability.</span>
